İlkokul Öğrencilerinde Floresan ile Somutlaştırma Girişiminin Kullanılmasının El Hijyeni Eğitimine Etkisi

Yıl 2024, , 255 - 264, 05.12.2024

Hülya Yılmaz , Cevriye Yüksel Kaçan

https://doi.org/10.48071/sbuhemsirelik.1434939

Öz

Giriş: Yetersiz el hijyeni nedeniyle çocukluk çağındaki bulaşıcı hastalık ve ölüm oranları dakikada bir çocuğun
ölümüne yol açmaktadır.
Amaç: Eğitim stratejisi olarak floresan ile somutlaştırma girişiminin kullanıldığı programın ilkokul öğrencilerinin
el yıkama becerileri üzerindeki etkilerini incelemektir.
Yöntem: Ön test ve son test desenli, tek merkezli randomize kontrollü çalışma, 35 deney ve 35 kontrol katılımcısıyla yürütüldü. Veriler, ultraviyole ışık altında floresanla tespit edilebilen Dermalux Test Losyonu, Sosyodemografik Veri Formu, El Yıkama Beceri Kontrol Listesi, El Yıkama Beceri Etkinliği ve Okul Çocuklarında El Hijyeni Değerlendirme Soru Formu ile toplandı.
Bulgular: Eğitim öncesi ve sonrası deney grubunda yer alan katılımcıların her iki el için verilen el yıkama etkinliğinde
bölgelere göre istatistiksel fark tespit edilmiştir (p < 0,001). Eğitim öncesi ve sonrası tüm katılımcılarda el yıkama kontrol listesi puan ortalamalarında ve el yıkama sürelerinde artış tespit edilmiştir (p < 0,05). Eğitim öncesi ve sonrası el yıkama kontrol listesi puan ortalamaları değişim yüzdesi karşılaştırıldığında deney grubundaki değişimin %62’ye, kontrol grubundakinin ise %23’e yükseldiği tespit edilmiştir (p < 0,001).
Sonuç: Öğrencilere görsel somutlaştırma ve açıklama yapılması ile el yıkama etkinliğini geliştirmektedir. Bu
nedenle okul çağındaki çocukların eğitiminde bu tür görsel geri bildirim sağlayan teknolojik cihazların kullanılması
önemle tavsiye edilmektedir.

Anahtar Kelimeler

eğitim, el hijyeni, el yıkama, okul hemşireliği

Etik Beyan

Before starting the study, ethical permission for the research was obtained from the Clinical Research Ethics Committee of one University Medical Faculty (Approval No. 2023-1/46 and dated 11 January 2023). Institutional permission (E-94060517-604.02-70406724) was obtained from the Provincial Directorate of National Education for the school where the study was conducted. Active written consent was obtained from students, their parents, or caregivers through the school administration before they were enrolled in the study.

Teşekkür

The authors extend their sincerest gratitude to the primary school students, their parents, or caregivers through the school administration.

The Effect of Using Fluorescent Concretization Intervention on Hand Hygiene Training in Primary School Students

Öz

Introduction: Inadequate hand hygiene increases the rates of childhood infectious diseases and deaths, leading to the death of one child per minute.
Aim: The aim of the study was to examine the effects of the program in which fluorescent embodiment intervention was used as an educational strategy on the hand washing skills of primary school students.
Method: Single center randomized controlled trial using a pretest and posttest design was conducted with 35 intervention and 35 control participants. Data were collected with Dermalux Test Lotion containing fluorescently detectable under ultraviolet light, Sociodemographic Data Questionnaire, Hand Washing Skill Checklist, Hand Washing Skill Efficacy, and Hand Hygiene Assessment Question Form in School Children.
Results: A statistical difference was found in the hand washing activity given for both hands of the participants in the experimental group before and after the training (p < 0.001). There was an increase in the mean hand washing checklist scores and hand washing times of all participants before and after the training (p < 0.05). When the percentage of change in the mean hand washing checklist scores before and after the training was compared, it was found that the change in the experimental group increased to 62% and in the control group to 23% (p < 0.001).
Conclusion: Visual concretization and explanation improve hand washing activity. Therefore, it is highly recommended to use technological devices that provide such visual feedback in the education of school-age children.

Anahtar Kelimeler

education, hand hygiene, hand washing, school nursing

Kaynakça

• Ákos, L., András, F., Ágnes, L., Rita, F. A., Edina, G., Sarolta, M. D., …, & Judit, F. H. (2018). Direct effect of contemporary health education programmes on the knowledge about hand hygiene and technique of hand washing in primary school age children. Orvosi Hetilap, 159(12), 485-490. doi:10.1556/650.2018.31031
• Alzaher, A. A., Almudarra, S. S., Mustafa, M. H., & Gosadi, I. M. (2018). The importance of hand hygiene education on primary schoolgirls’ absence due to upper respiratory infections in Saudi Arabia a cluster randomized controlled trial. Saudi Medical Journal, 39(10), 1044-1049. doi:10.15537/ smj.2018.10.23344
• Appiah-Brempong, E., Newton, S., Harris, M. J., & Gulis, G. (2020). Effect of a theory-based hand hygiene educational intervention for enhancing behavioural outcomes in Ghanaian schools: A cluster-randomised controlled trial. International Journal of Public Health, 65, 99-109. doi:10.1007/s00038-019-01310-4
• Behzadkolaee, S. M. A., Mirmohammadi, S. T., Yazdani, J., Gorji, A. M. H., Toosi, A., Rokni, M., & Gorji, M. A. H. (2015). Health, safety and environment conditions in primary schools of Northern Iran. Journal of Natural Science, Biology, and Medicine, 6(1), 76-79. doi: 10.4103/0976-9668.149094
• Berhanu, A., Mengistu, D. A., Temesgen, L. M., Mulat, S., Dirirsa, G., Alemu, F. K., ..., & Geremew, A. (2022). Hand washing practice among public primary school children and associated factors in Harar town, eastern Ethiopia: an institution-based cross sectional study. Frontiers in Public Health, 10, 975507. doi: 10.3389/fpubh.2022.975507
• Bilici, S., & Buzgan, T. (Eds.). (2008). Hand hygiene for primary school children. Ministry of Health, General Directorate of Basic Health Services Nutritionand Physical Activities Department. Ankara, Turkey.
• Biswas, D., Ahmed, M., Roguski, K., Ghosh, P. K., Parveen, S., Nizame, F. A., ..., & Iuliano, A. D. (2019). Effectiveness of a behavior change intervention with hand sanitizer use and respiratory hygiene in reducing laboratory-confirmed influenza among schoolchildren in Bangladesh: A cluster randomized controlled trial. American Journal of Tropical Medicine and Hygiene, 101(6), 1446-1455. doi: 10.4269/ajtmh.19-0376
• Black, M., Barnes, A., Strong, M., Brook, A., Ray, A., Holden, B., ..., & Taylor-Robinson, D. (2021). Relationships between child development at school entry and adolescent health-a participatory systematic review. International Journal of Environmental Research and Public Health, 18(21), 11613. doi: 10.3390/ijerph182111613
• Canton, H. (2021). United Nations Children’s Fund—UNICEF. In The Europa Directory of International Organizations 2021 (pp. 160-172). Routledge.
• Centers for Disease Control and Prevention. (2016). When & How to Wash Your Hands. Retrieved Date: 17.07.2022. Retrieved From: https://www.cdc.gov/handwashing/when-how-handwashing.html
• Centers for Disease Control and Prevention. (2019). Handwashing in communities: Clean hands save lives. Hand hygiene at school. Retrieved Date: 28.07.2023. Retrieved From: https://www.cdc.gov/handwashing/handwashing-school.html
• Chen, X., Ran, L., Liu, Q., Hu, Q., Du, X., & Tan, X. (2020). Hand hygiene, mask-wearing behaviors and its associated factors during the COVID-19 epidemic: A cross-sectional study among primary school students in Wuhan, China. International Journal of Environmental Research and Public Health, 17(8), 2893. doi: 10.3390/ijerph17082893
• International Committee of Medical Journal Editors. (1997). Uniform requirements for manuscripts submitted to biomedical journals. Pathology, 29(4), 441-447. doi:10.1080/00313029700169515
• Dreibelbis, R., Kroeger, A., Hossain, K., Venkatesh, M., & Ram, P. K. (2016). Behavior change without behavior change communication: Nudging handwashing among primary school students in Bangladesh. International Journal of Environmental Research and Public Health, 13(1), 129. doi: 10.3390/ijerph13010129
• Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149-1160. doi:10.3758/BRM.41.4.1149
• Fishbein, A., Tellez, I., Lin, H., Sullivan, C., & Groll, M. (2011). Glow gel hand washing in the waiting room: A novel approach to improving hand hygiene education. Infection Control and Hospital Epidemiology, 32(7), 661-666. doi: 10.1086/660359
• Fishbein, M., & Ajzen, I. (2009). Predicting and changing behavior: the reasoned action approach. (1st ed.). Psychology Press. doi: 10.4324/9780203838020
• Ibeneme, S., Maduako, V., Ibeneme, G. C., Ezuma, A., Ettu, T. U., Onyemelukwe, N. F., ..., & Fortwengel, G. (2017). Hand hygiene practices and microbial investigation of hand contact swab among physiotherapists in an Ebola endemic region: implications for public health. BioMed Research International, Epub2017, 1-13, 5841805. doi: 10.1155/2017/5841805
• Kampf, G., Reichel, M., Feil, Y., Eggerstedt, S., & Kaulfers, P. M. (2008). Influence of rub-in technique on required application time and hand coverage in hygienic hand disinfection. BMC Infectious Diseases, 8(1), 1-11. doi: 10.1186/1471-2334-8-149
• Kang, Y. S., & Chang, Y. J. (2019). Using a motion-controlled game to teach four elementary school children with intellectual disabilities to improve hand hygiene. Journal of Applied Research in Intellectual Disabilities, 32(4), 942-951. doi: 10.1111/jar.12587
• Kısacık, Ö. G., Ciğerci, Y., & Güneş, Ü. (2021). Impact of the fluorescent concretization intervention on effectiveness of hand hygiene in nursing students: A randomized controlled study. Nurse Education Today, 97, 104719. doi: 10.1016/j.nedt.2020.104719.
• Loschiavo, J. (2015). Fast facts for the school nurse: School nursing in a nutshell. New York, NY: Springer.
• Mbakaya, B. C., Kalembo, F. W., & Zgambo, M. (2020). Use, adoption, and effectiveness of tippy-tap handwashing station in promoting hand hygiene practices in resource-limited settings: A systematic review. BMC Public Health, 20(1), 1-25. doi: 10.1186/s12889-020-09101-w
• Mbakaya, B. C., Lee, P. H., & Lee, R. L. (2017). Hand hygiene intervention strategies to reduce diarrhoea and respiratory infections among schoolchildren in developing countries: A systematic review. International Journal of Environmental Research and Public Health, 14(4), 371. doi: 10.3390/ijerph14040371
• Mbakaya, B. C., Lee, P., & Lee, R. L. T. (2019). Effect of a school-based hand hygiene program for Malawian children: A cluster randomized controlled trial. American Journal of Infection Control, 47(12), 1460-1464. doi: 10.1016/j.ajic.2019.06.009
• McMichael, C. (2019). Water, sanitation and hygiene (WASH) in schools in low-income countries: A review of evidence of impact. International Journal of Environmental Research and Public Health, 16(359), 1-21. doi: 10.3390/ijerph16030359
• Morton, J. L., & Schultz, A. A. (2004). Healthy hands: Use of alcohol gel as an adjunct to handwashing in elementary school children. The Journal of School Nursing, 20(3), 161-167. doi: 10.1177/10598405040200030601
• Mumma, J. M., Durso, F. T., Casanova, L. M., Erukunuakpor, K., Kraft, C. S., Ray, S. M., …, & DuBose, J. (2019). Variability in the duration and thoroughness of hand hygiene. Clinical Infectious Diseases, 69(Supplement 3), 221-223. doi: 10.1093/cid/ciz612
• Nicholson, J. A., Naeeni, M., Hoptroff, M., Matheson, J. R., Roberts, A. J., Taylor, D., …, & Wright, R. L. (2014). An investigation of the effects of a hand washing intervention on health outcomes and school absence using a randomised trial in Indian urban communities. Tropical Medicine & International Health, 19(3), 284-292. doi: 10.1111/tmi.12254
• Ozcan, A., Ozdil, K., Kaya, S. S., & Sezer, F. (2020). Hand washing in primary school students using “demonstration, puzzle, dance, song”: A nursing project based on multifaceted skills training. The Journal of Continuing Education in Nursing, 51(4), 158-166. doi: 10.3928/00220124-20200317-05
• Öncü, E., & Vayısoğlu, S. K. (2021). Duration or technique to improve the effectiveness of children’s hand hygiene: A randomized controlled trial. American Journal of Infection Control, 49(11), 1395-1401. doi: 10.1016/j.ajic.2021.03.012
• Öncü, E., Köksoy Vayısoğlu, S., Lafci, D., Yurtsever, D., Ravlı Bulut, E., & Peker, E. (2019). Comparison of interactive education versus fluorescent concretization on hand hygiene compliance among primary school students: A randomized controlled trial. The Journal of School Nursing, 35(5), 337–347. doi: 10.1177/1059840518785447
• Pasupuleti, D., Sasidharan, S., Manikutty, G., Das, A. M., Pankajakshan, P., & Strauss, S. (2023). Co-designing the embodiment of a minimalist social robot to encourage hand hygiene practises among children in India. International Journal of Social Robotics, 15(2), 345-367. doi: 10.1007/ s12369-023-00969-3
• Pan, S. C., Chen, E., Tien, K. L., Hung, I. C., Sheng, W. H., Chen, Y. C., & Chang, S. C. (2014). Assessing the thoroughness of hand hygiene: “seeing is believing”. American Journal of Infection Control, 42(7), 799-801. doi: 10.1016/j.ajic.2014.03.003
• Priest, P., McKenzie, J. E., Audas, R., Poore, M., Brunton, C., & Reeves, L. (2014). Hand sanitiser provision for reducing illness absences in primary school children: A cluster randomised trial. PLoS Medicine, 11(8), e1001700. doi: 10.1371/journal.pmed.1001700
• Shimada, S., Funahashi, K., Ito, K., Tanase, Y., & Iwazaki, K. (2017). VR hand hygiene training system that visualizes germs to be washed and removed. 2017 IEEE 6th Global Conference on Consumer Electronics, 1-4. doi: 10.1109/GCCE.2017.8229333
• Škodová, M., Urra, F. G., Benítez, A. G., Romano, M. R. J., & Ortiz, A. G. (2015). Hand hygiene assessment in the workplace using a UV lamp. American Journal of Infection Control, 43(12), 1360-1362. doi: 10.1016/j.ajic.2015.07.003
• Snow, M., White, G. L., & Kim, H. S. (2008). Inexpensive and time-efficient hand hygiene interventions increase elementary school children’s hand hygiene rates. Journal of School Health, 78(4), 230-233. doi: 10.1111/j.1746-1561.2008.00291.x
• Suen, L. K., Wong, J. W., Lo, K. Y., & Lai, T. K. (2019). The use of hand scanner to enhance hand hygiene practice among nursing students: A single-blinded feasibility study. Nurse Education Today, 76, 137-147. doi: 10.1016/j.nedt.2019.01.013
• Şimşek, D. C. (2012). İlköğretim birinci sınıf öğrencilerine verilen planlı el yıkama eğitiminin el yıkama davranışı üzerine etkisinin belirlenmesi. Doctoral Dissertation. Başkent Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Ana Bilim Dalı. Ankara. Retrieved Date: 17.07.2022. Retrieved From: https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp
• Tai, J. W. M., Mok, E. S. B., Ching, P. T. Y., Seto, W. H., & Pittet, D. (2009). Nurses and physicians’ perceptions of the importance and impact of healthcare-associated infections and hand hygiene: A multi-center exploratory study in Hong Kong. Infection, 37, 320-333. doi: 10.1007/ s15010-009-8245-x
• Thanh Xuan, L. T., & Hoat, L. N. (2013). Handwashing among schoolchildren in an ethnically diverse population in northern rural Vietnam. Global Health Action, 6(1),18869. doi: 10.3402/gha.v6i0.18869
• Uyanık, G., & Dağhan, Ş. (2022). Turkish validity and reliability of hand hygiene assessment question form in school children. Journal of Continuing Medical Education, 31(3), 201-208. doi: 10.17942/sted.984416
• Wong, J. S., & Lee, J. K. F. (2019). The common missed handwashing instances and areas after 15 years of hand-hygiene education. Journal of Environmental and Public Health, 8,1-7. doi: 10.1155/2019/5928924
• World Health Organization. (2009). Water, sanitation and hygiene standards for schools in low-cost settings. Adams, J., Bartram, J., Chartier, Y., & J. Sims (Eds.). Retrieved Date: 06.07.2022. Retrieved From: http://www.who.int/water_sanitation_health/publications/wash_standards_school.pdf
• World Health Organization. (2012). Health statistics and information systems: Cause-specific mortality estimates for 2000-2012. Retrieved Date: 06.07.2023. Retrieved From: https://www.who.int/healthinfo/global_burden_ disease/estimates/en/ (Accessed July 6, 2023).
• Zingg, W., Haidegger, T., & Pittet, D., (2016). Hand coverage by alcohol-based handrub varies: Volume and hand size matter. American Journal of Infection Control, 44(12), 1689-1691. doi: 10.1016/j.ajic.2016.07.006